Vega Alma, Porteny Thalia, Aguila Emma
Kaiser Permanente, Regional Utilization Management, 393 E. Walnut Street, Pasadena, CA, 91188, USA.
Department of Health Policy, Harvard University, Cambridge, MA, USA.
J Immigr Minor Health. 2018 Dec;20(6):1468-1475. doi: 10.1007/s10903-018-0693-x.
Immigrants are ineligible for federally-funded Medicaid in the U.S. until at least 5 years after arrival. There is little information on where they receive care in light of this restriction. Using Blinder-Oaxaca decomposition, this study examines whether the setting in which older recent immigrants receive care (i.e., health clinic, emergency room or doctor's office) explains delays in care. Among older adults with a usual source of care, 13.5% of recent immigrants had not seen a health professional in the past year compared to 8.6% of non-recent immigrants and 6.3% of native-born. Approximately 23% of these differences is attributable to recent immigrants' tendency to receive care in clinics and community health centers. Even when older recent immigrants manage to find a usual source of care, it is of lower quality than that received by their non-recent immigrant and native-born counterparts.
在美国,移民至少在抵达后5年内没有资格获得联邦政府资助的医疗补助。鉴于这一限制,关于他们在哪里接受治疗的信息很少。本研究使用布林德-奥克萨卡分解法,考察近期老年移民接受治疗的场所(即健康诊所、急诊室或医生办公室)是否能解释治疗延迟的问题。在有固定医疗服务来源的老年人中,过去一年里,13.5%的近期移民没有看过医疗专业人员,相比之下,非近期移民的这一比例为8.6%,本土出生者为6.3%。这些差异中约23%可归因于近期移民倾向于在诊所和社区健康中心接受治疗。即使近期老年移民设法找到了固定的医疗服务来源,其质量也低于非近期移民和本土出生者所接受的医疗服务质量。